"The patient was diagnosed with pulmonary torsion before surgery. Due to the long course of the disease, when he was admitted to our hospital for treatment, his condition suddenly worsened." Su Yun began to introduce, "Lao He, please turn down the sound of the song!"
Lao He pretended not to hear and went to adjust the ventilator.
"Boss, tell me about Lao He." Su Yun was dissatisfied.
"Thorax opener." Zheng Renze didn't hear it. He reached for the chest opener, stuffed it into the chest, and started to tighten the screws.
With a rattling sound, the chest was opened. The size is just right, the ribs have maximum elasticity, but there are no fractures.
"During the operation, it was found that the middle lobe of the right lung was displaced upward and rotated counterclockwise about 170°. It is a very standard value, because various textbooks say 180°." Su Yunlianmai began to chatter, "The congestion of the lungs can be seen with the naked eye. It’s serious, there are already ischemic lesions at the edges.”
He knew why Zheng Ren was in such a hurry, because if he followed the steps, maybe within 5 minutes, the edge necrosis would be permanently dead, making ischemia-reperfusion impossible.
And if there is complete necrosis, blood perfusion after correcting the torsion will bring all the necrotic tissue into the body's blood circulation.
That's how bacteremia appears.
If it is too late and similar problems are found, direct removal of the lung lobes is the best option.
What will the boss choose
Su Yun was chattering while assisting Zheng Ren.
His actions have to be delayed a little bit, because in Lianmai live broadcast, you can't ask or communicate, and the quality of Lianmai's players is extremely high.
Zheng Ren didn't hesitate, he directly started to release his right lung.
"Generally, for pulmonary torsion, the surgical option is resection. But our 912 emergency response level is high. Without wasting time, the patient's lungs are not necrotic yet, so they can choose to preserve them." Su Yun said.
Lin Ge walked in and happened to hear these words.
This sentence was like the sound of the Nine Heavens Sanskrit, making him happy in his heart. Boss Zheng did not forget to advertise to 912 even though he was doing a live surgery. He was so generous!
"Lao He, get ready!" Zheng Ren said.
"Ready."
With the assistance of Su Yun, Zheng Ren reversed the middle lobe of the right lung and restored the original anatomical structure.
Lao He's fiberoptic bronchoscope and sputum suction tube had already been inserted.
"The power of anesthesia is very important. The anesthesiologist uses a fiber bronchoscope to suction sputum under direct vision. Boss, give Lao He a lens." Su Yundao said.
Zheng Ren raised his head and glanced at Lao He.
Lao He was happy in his heart, but had no expression on his face. He used the fiberoptic bronchoscope to suction sputum seriously and attentively. Try to express the grandeur of a great anesthesiologist in his imagination and strive for perfection.
"A large amount of plasma-laced sputum was sucked out. Why there is such secretion, I will not explain in detail." Su Yun said while starting to deal with the bleeding spots left when Zheng Ren just opened his chest.
Bang bang bang bang, the electric burner is flying, and when it touches the bleeding point, it leaves immediately.
There is nothing to explain here, and Su Yun said it lazily. Fang Lin used hemostatic forceps to cooperate with Su Yun to stop the bleeding.
Zheng Ren remained motionless, staring at the middle lobe of the patient's right lung.
"The surgeon is observing the blood supply of the patient's right middle lobe of the lung. Looking at it now, the right middle lobe of the lung should be preserved." Su Yun stopped the bleeding while talking about what Zheng Ren was doing.
"Now I have a question for you who are watching the live broadcast - in the next 20 to 60 minutes, blood tests will be taken continuously. What items do the surgeons need to check?" Su Yun said.
Fang Lin was also a little surprised. He thought hard and then asked in a low voice: "Brother Yun, do you want to check the serum potassium and lactate dehydrogenase?"
"Alas, after so many years, there is no tacit understanding at all." Su Yun sighed and said, "Everyone with good ears will hear what you say."
"..." Fang Lin lowered his head and used a hemostat to expose Su Yun's blood vessels.
Small ones can be burned directly, while large ones need to be ligated.
This side was quickly processed, and the three of them stood on the operating table, nothing happened.
I was very busy before the performance. After opening the chest and resetting the middle lobe of the right lung, the situation changed from extremely dynamic to static.
This kind of surgery is generally rare, and the most common one is to wait for freezing during the operation. In a well-trained hospital, 20-30 minutes in the pathology department is enough to produce results.
But it's a bit weird to live-stream the surgery and just keep waiting.
Su Yun took advantage of the waiting time and began to tell the patient's previous medical history to the sound of good luck singing.
He had an excellent memory. He took out the laboratory test sheet that he had only read once in the thoracic surgery department before the operation and began to analyze it logically.
Time passed quickly, and blood was drawn three times in a row, but the values of serum potassium and lactate dehydrogenase did not increase significantly.
Zheng Ren let out a sigh of relief.
The patient's lungs should have been saved.
"There are no problems with serum potassium and lactate dehydrogenase. Now the operator starts to explore." Su Yun began to say to Mai: "It's been an hour, and the operator finally moved! Friends who are watching the live broadcast, do you have any traces of it? A little excited?"
Zheng Ren asked while detecting the pulses of V4 and V5: "Were you so out of tune when doing the live broadcast for Liu Xuzhi?"
"Boss, do you have to be serious about your surgery? Friends, did you hear the background music? Taste it! It's hard to believe that the world's top surgeon actually likes this song."
Zheng Ren ignored this guy and was broadcasting live. He couldn't hit him in the face with a hemostatic forceps.
Reach out and clap the needle holder into the palm of your hand.
Zheng Ren began to suture the middle lobe of the right lung and the lower lobe of the right lung.
This is to prevent the middle lobe of the right lung from twisting again after surgery. If the ligament is missing or weak, it should be fixed to the other lobes.
"One hour after returning to normal physiological structure, the bloody sputum disappeared." Su Yun explained as he watched the sputum suction tube in Lao He's hand suck out only a small amount of white foamy sputum and began to take out the fiber bronchoscope.
"Why do we have to wait for an hour? The first thing is to observe whether the middle lobe of the patient's right lung can be preserved. I... The surgeon will not easily perform a simple and crude operation that is extremely damaging."
"Removing a lobe will cause the patient's respiratory function to suffer about 20% loss. Although it will not affect life, it will affect the quality of life to some extent."
"The one hour of waiting during surgery means an improvement in the patient's quality of life for decades after surgery."
"That's a doctor's job, isn't it, boss."
"It's the surgery, please talk less." Zheng Ren felt that opening the microphone was really unreliable, and Su Yun was usually fine with talking and laughing. But today, when the microphone was turned on, no one else spoke, only Su Yun spoke.
I didn't feel much about the singing of "Good Luck Comes" at first, but today I felt that Su Yun's voice was mixed with the singing of "Good Luck Comes Coming", which was very harsh.
"In order to control airway secretions, the patient is mechanically ventilated for about 12 hours after surgery, and the patient's condition is observed before extubation."
"Because there may be thrombus remaining in the pulmonary vein stump, anti-thrombotic treatment with warfarin is given after surgery."